摘要
目的探讨高、低频超声所观察肝实质形态的细微变化与肝组织纤维化的关系。方法用高、低频超声观察216例慢性乙型肝炎肝实质形态的表现并对肝活组织进行纤维化程度的判断(从S0的无纤维化到S4的肝硬化)。高、低频超声依点、线状回声的不同表现分为5级(细短线、稍粗短线、粗短线、粗条纹、索条纹)。卡方检验判断组间的显著性差异,Sperman相关来判断超声表现与纤维化的关系程度。结果 S1到S4肝实质形态的超声表现为细短线向粗短线、粗条纹、索条纹发展。在S1与S2之间高、低频超声有不同的肝实质形态表现,S3与S4则没有显著的区别。高、低频超声的肝实质形态改变均与肝纤维化程度呈正相关(r=0.5513、0.4858),高频较低频超声具有更高的结节检出率(61.67%vs.27.31%;χ2=49.96,P<0.01),与肝纤维化程度呈正相关(r=0.54372、0.30208)。结论高、低频超声均能检测到肝组织纤维化的存在,并能判断肝纤维化的程度。高频超声检测肝纤维化结节具有更高的精确性。
Objective To determine whether subtle changes in hyperechoic findings from low-/high-frequency ultrasound analysis of liver biopsy specimens from patients with chronic hepatitis correlate with differences in liver parenchyma morphology associated with presence and extent of fibrosis.Methods Spatially-matched liver parenchyma biopsy specimens from 216 patients with chronic hepatitis（hepatitis b virus infection） were subjected to both low-and high-frequency ultrasound,as well as conventional histological analysis,which was used to score the extent of fibrosis（progressive staging： S1,no fibrosis,through S4,cirrhosis）.The low-and high-frequency point-like echo and echo performance,respectively,were used to classify samples among one of five fractionating features（fine,thick,coarse/crude,irregular/nonlinear,cable stripes）.Significance of intergroup differences was assessed by Chi-squared test.Spearman′s correlation coefficient was used to assess the correlation between the ultrasound findings and histological fibrosis stage.Results The changes in echoic findings paralleled progressive deterioration in fibrosis stage： from fine to thicker,uneven,and cable stripe shapes along stages S0 to S4.Both the low-and high-frequency ultrasound findings could differentiate changes in liver parenchyma morphology associated with S1（low-frequency： χ2=76.52 vs.S2,χ2=71.91 vs.S3,χ2=59.43 vs.S4;high-frequency： χ2=76.52 vs.S2,χ2=71.91 vs.S3,χ2=59.43 vs.S4;all P0.01） and S2（low-frequency： χ2=5.17 vs.S3,χ2=21.25 vs.S4;high frequency： χ2=23.67 vs.S3,χ2=34.80 vs.S4;all P0.01）.There were no significant differences associated with either low-or high-frequency ultrasound findings for S3 or S4.The low-and high-frequency ultrasound liver parenchyma fractionation were postively correlated to liver fibrosis staging（r=0.4858 and r=0.5513,respectively）.The high-frequency ultrasound had a significantly higher positive rate of detecting nodules than the low-frequency ultrasound（61.67% vs.27.31%;χ2=49.96,P0.01）,and the positive rates were positively correlated with liver fibrosis stage（low-frequency： r=0.5437;high-frequency： r=0.3021）.Conclusion While both low-and high-frequency ultrasound allow for detection of liver fibrosis and differentiation of some fibrotic stages,the high-frequency ultrasound findings are superior for detecting fibrotic nodules.
出处
《临床肝胆病杂志》
CAS
2013年第5期359-362,共4页
Journal of Clinical Hepatology
关键词
超声检查
肝炎
乙型
慢性
肝硬化
ultrasonography
hepatitis B
chronic
liver cirrhosis
